My long-term career goal is to develop a global health research-training program for United States and international physician-scientists with a focus on HIV and tuberculosis. The goals of this K24 proposal are to train physician scientists and outstanding pre-doctoral students through the conduct of research primarily in Haiti, and also in Tanzania and to conduct a new research project on HIV induced chronic inflammation in Haiti. United States trainees will spend ~60% of their time at international research sites in Haiti and Tanzania, which have on-site Weill Cornell faculty, advanced telecommunications, and outstanding environments for research training. Physician-scientists may pursue a Master of Science (MS) in Clinical Epidemiology and Health Services Research at Weill Cornell Medical College. The research strategy includes a new research project in Haiti to be supported by the K24 award on HIV induced chronic inflammation (AIM 1), currently funded projects in Haiti (AIMS 2 - 5), and a currently funded project at a new research site in Mwanza, Tanzania (AIM 6). The common theme is that all the projects have patient-oriented research on AIDS and TB as the focus and will serve as training vehicles for research trainees. The projects include the following: 1. Chronic inflammation as a consequence of delayed ART: biomarkers and sequelae 2. Cervical cancer in HIV infected women: role of prostaglandin E2 3. Tuberculosis biomarkers for diagnosis and for monitoring therapy 4. HIV vaccine and ART clinical trials 5. Multidrug resistant tuberculosis surveillance and control 6. Female urogenital schistosomiasis and HIV interactions Five of the projects involve long-term study of cohorts in Haiti, and the sixth a cohot in Tanzania. There are both clinical and laboratory aspects to all studies which offer trainees broad experience. Trainees learn through the conduct of an independent project and the opportunity to interact with colleagues working on studies other than their own. PUBLIC HEALTH RELEVANCE: The K24 proposal will support Dr Daniel Fitzgerald to train physician scientists and outstanding pre-doctoral students through the conduct of HIV and tuberculosis research primarily in Haiti, and also in Tanzania and to conduct a new project on HIV induced chronic inflammation in Haiti. Physician-scientist trainees may also pursue a Master of Science (MS) in Clinical Epidemiology and Health Services Research at Weill Cornell Medical College.